Literacy and cognitive change among ethnically diverse elders

Research concerned with relations between literacy level and assessment of cognition among ethnically diverse elders is presented. The evidence suggests that literacy has a profound effect on neuropsychological measures across verbal and nonverbal domains, and that this effect is independent of other demographic and experiential factors such as age, years of education, sex, ethnicity, and language use. It appears that reading level is a more sensitive predictor of baseline test performance, and also that literacy skills are protective against memory decline. Adjustment for reading level, which in part reflects quality of education, overcomes the limitations of years of education as an index of educational experience among multicultural elders and thus can improve the specificity of certain neuropsychological measures. Differences in organization of visuospatial information, lack of previous exposure to stimuli, and difficulties with interpretation of the logical functions of language are possible factors that affect test performance of elders with low levels of literacy.